胸膜孤立性纤维瘤的临床特点及MSCT影像表现

Clinical characteristics and MSCT findings of solitary fibrous tumors of pleura

目的分析胸膜孤立性纤维瘤(SFTP)的临床特点及多层螺旋CT(MSCT)影像表现,提高对SFTP的认识,减低术前误诊率。方法收集整理我院2012-2017年间13例经病理证实的SFTP患者的资料(包括MSCT和MRI图像),对MSCT图像进行多平面重建(MPR)处理,结合文献回顾性分析病灶所处的位置、边缘、强化方式等特点。结果患者临床表现无特异性,左右胸腔及纵隔内病灶多呈单发,肿瘤较大时呈分叶状,瘤体最长径为(3.2-12.4)cm,平均(8.7±2.5)cm;CT平扫图像病症密度均匀者7例,内见混杂密度或钙化者6例,增强扫描不均匀强化共9例,其内能见到强化的混杂血管影,呈"地图样"改变,MPR图像示病灶周围见不张肺组织或伴有胸膜增厚的胸膜凹陷征。结论 SFTP有特征性MSCT表现,典型表现呈"地图样"不均匀强化,其对术前诊断有重要价值。

Objective To study the clinical characteristics and MSCT findings of solitary fibrous tumors of pleura( SFTP),in order to improve the knowledge and decrease misdiagnosis rate of SFTP. Methods The data of13 cases of SFTP confirmed by pathology in our hospital during 2012-2017 were collected( including MSCT and MRI images). The image of MSCT were processed with multi-planar reconstruction( MPR). The characteristics of the lesion such as location,margin and enhancement manner were analyzed retrospectively in combination with related literature. Results No distinctive clinical manifestation was found. Lesions in the pleural and mediastinum were solitary,and the larger tumors were lobulated. The diameter of tumors was( 3. 2-12. 4) cm,mean( 8. 7 ± 2. 5) cm.There were 7 cases appearing even density,6 uneven density including 1 case of calcification in plain CT,and 9 cases of uneven enhancement. Disorganized vessels and 'geographic pattern'enhancement were found in lesions,and MPR could display the atelectasis or the pleural indentation with pleural thickening nearing the tumor. Conclusion The MSCT findings of SFTP have some certain characteristic features. Heterogeneous enhancement is found and tumors appear as 'geographic pattern'. MSCT has important diagnostic value before operation.